Post-transplant diabetes mellitus and preexisting liver disease-a bidirectional relationship affecting treatment and management  

作　　者：Maja Cigrovski Berkovic Lucija Virovic-Jukic Ines Bilic-Curcic Anna Mrzljak 

机构地区：[1]Department of Kinesiological Anthropology and Methodology,Faculty of Kinesiology,University of Zagreb,Zagreb 10000,Croatia [2]Clinical Hospital Dubrava,Zagreb 10000,Croatia [3]Department of Pharmacology,Faculty of Medicine,University of J.J.Strossmayer Osijek,Osijek 31000,Croatia [4]School of Medicine,University of Zagreb,Zagreb 10000,Croatia [5]Department of Medicine,Division of Gastroenterology and Hepatology,Sisters of Charity University Hospital,Zagreb 10000,Croatia

出　　处：《World Journal of Gastroenterology》2020年第21期2740-2757,共18页世界胃肠病学杂志（英文版）

摘　　要：Liver cirrhosis and diabetes mellitus(DM)are both common conditions with significant socioeconomic burden and impact on morbidity and mortality.A bidirectional relationship exists between DM and liver cirrhosis regarding both etiology and disease-related complications.Type 2 DM(T2DM)is a wellrecognized risk factor for chronic liver disease and vice-versa,DM may develop as a complication of cirrhosis,irrespective of its etiology.Liver transplantation(LT)represents an important treatment option for patients with end-stage liver disease due to non-alcoholic fatty liver disease(NAFLD),which represents a hepatic manifestation of metabolic syndrome and a common complication of T2DM.The metabolic risk factors including immunosuppressive drugs,can contribute to persistent or de novo development of DM and NAFLD after LT.T2DM,obesity,cardiovascular morbidities and renal impairment,frequently associated with metabolic syndrome and NAFLD,may have negative impact on short and long-term outcomes following LT.The treatment of DM in the context of chronic liver disease and post-transplant is challenging,but new emerging therapies such as glucagon-like peptide-1 receptor agonists(GLP-1RAs)and sodium–glucose cotransporter 2 inhibitors(SGLT2i)targeting multiple mechanisms in the shared pathophysiology of disorders such as oxidative stress and chronic inflammation are a promising tool in future patient management.

关 键 词：Diabetes mellitus Liver transplantation Non-alcoholic fatty liver disease Metabolic syndrome INSULIN-RESISTANCE Glucagon-like peptide-1 receptor agonists Sodium–glucose cotransporter 2 inhibitors 

分 类 号：R587.1[医药卫生—内分泌] R657.3[医药卫生—内科学]